Joan J Ryoo

Publications of Joan J Ryoo

• Reconsidering the Veterans Health Administration: a model and a moment for publicly funded health care delivery.

  Authors: Joan J Ryoo, Jennifer L Malin

  Annals of internal medicine. 06/2011; 154(11):772-3.

• Emerging importance of certification: Volume, outcomes, and regionalization of care.

  Authors: Stanley K Frencher, Joan J Ryoo, Clifford Y Ko

  Journal of surgical oncology. 12/2008;

• Minimizing disparities in surgical care: a research focus for the future.

  Authors: Joan J Ryoo, Clifford Y Ko

  World journal of surgery. 05/2008; 32(4):516-21.

  The wide array of questions and opportunities for surgical health services research offers important prospects for inquiry into surgical disparities. In this essay we discuss research that directlyThe wide array of questions and opportunities for surgical health services research offers important prospects for inquiry into surgical disparities. In this essay we discuss research that directly or indirectly addresses disparities in surgery, highlighting the strengths and the future directions such research efforts intimate as potential foci of collective attention. We then consider possible research approaches-including community-based participatory models-for confronting disparity and the potential role of research in quality improvement to help achieve the ultimate aim, an optimal level of health care for all.

• Diminishing disparities: starting in our own backyards.

  Authors: Joan J Ryoo, Sushma Jain, Clifford Y Ko

  Annals of surgical oncology. 04/2008; 15(3):674-6.

• Immunomodulatory drug CC-5013 overcomes drug resistance and is well tolerated in patients with relapsed multiple myeloma.

  Authors: Paul G Richardson, Robert L Schlossman, Edie Weller, Teru Hideshima, Constantine Mitsiades, Faith Davies, Richard Leblanc, Laurence P Catley, Deborah Doss, Kathleen Kelly, Mary McKenney, Julie Mechlowicz, Andrea Freeman, Reggie Deocampo, Rebecca Rich, Joan J Ryoo, Dharminder Chauhan, Kathe Balinski, Jerome Zeldis, Kenneth C Anderson

  Blood. 12/2002; 100(9):3063-7.

  Thalidomide (Thal) can overcome drug resistance in multiple myeloma (MM) but is associated with somnolence, constipation, and neuropathy. In previous in vitro studies, we have shown that the potentThalidomide (Thal) can overcome drug resistance in multiple myeloma (MM) but is associated with somnolence, constipation, and neuropathy. In previous in vitro studies, we have shown that the potent immunomodulatory derivative of thalidomide (IMiD) CC-5013 induces apoptosis or growth arrest even in resistant MM cell lines and patient cells, decreases binding of MM cells to bone marrow stromal cells (BMSCs), inhibits the production in the BM milieu of cytokines (interleukin-6 [IL-6], vascular endothelial growth factor [VEGF], tumor necrosis factor-alpha [TNF-alpha]) mediating growth and survival of MM cells, blocks angiogenesis, and stimulates host anti-MM natural killer (NK) cell immunity. Moreover, CC-5013 also inhibits tumor growth, decreases angiogenesis, and prolongs host survival in a human plasmacytoma mouse model. In the present study, we carried out a phase 1 CC-5013 dose-escalation (5 mg/d, 10 mg/d, 25 mg/d, and 50 mg/d) study in 27 patients (median age 57 years; range, 40-71 years) with relapsed and refractory relapsed MM. They received a median of 3 prior regimens (range, 2-6 regimens), including autologous stem cell transplantation and Thal in 15 and 16 patients, respectively. In 24 evaluable patients, no dose-limiting toxicity (DLT) was observed in patients treated at any dose level within the first 28 days; however, grade 3 myelosuppression developed after day 28 in all 13 patients treated with 50 mg/d CC-5013. In 12 patients, dose reduction to 25 mg/d was well tolerated and therefore considered the maximal tolerated dose (MTD). Importantly, no significant somnolence, constipation, or neuropathy has been seen in any cohort. Best responses of at least 25% reduction in paraprotein occurred in 17 (71%) of 24 patients (90% confidence interval [CI], 52%-85%), including 11 (46%) patients who had received prior Thal. Stable disease (less than 25% reduction in paraprotein) was observed in an additional 2 (8%) patients. Therefore, 17 (71%) of 24 patients (90% CI, 52%-85%) demonstrated benefit from treatment. Our study therefore provides the basis for the evaluation of CC-5013, either alone or in combination, to treat patients with MM at earlier stages of disease.

• Novel therapies for multiple myeloma.

  Authors: Joan J Ryoo, Craig Emmitt Cole, Kenneth C Anderson

  Blood reviews. 10/2002; 16(3):167-74.

  Multiple myeloma (MM) continues to evade cure by conventional therapies, increasing the urgency for new, biologically based treatments. Reviewed in this discussion are novel chemotherapies underMultiple myeloma (MM) continues to evade cure by conventional therapies, increasing the urgency for new, biologically based treatments. Reviewed in this discussion are novel chemotherapies under clinical trial that capitalize upon greater comprehension of tumor pathophysiology. In targeting tumor biology, these therapies serve as a model of treatment with great potential for improving outcomes in patients with MM.